Evidence Process for Abdominal Pain Guideline Research 11/16/2017. Guideline Review using ADAPTE method and AGREE II instrument 11/16/2017

Transcription

1 Evidence Process for Abdominal Pain Guideline Research Guideline Review using ADAPTE method and AGREE II instrument Approximately 139 Potentially relevant guidelines identified in various resources* 59 Selected for inclusion Approximately 80 Guidelines Excluded Exclusion Criteria: Non-English language Pediatrics Age of Publication Ex-U.S. focus Little or no discussion of advanced imaging 16 Consensus/Practice-based Guidelines 43 Evidence-based Guidelines evaluated using AGREE II 31 Guidelines meeting AGREE II inclusion threshold of combined total score 90 AND Rigor of Development Scaled Domain Score Percentage > 50% All were included in detailed ADAPTE recommendation analysis 12 Guidelines not meeting AGREE II inclusion threshold of combined total score 90 AND Rigor of Development Scaled Domain Score Percentage > 50% Ovid Medline, NCBI PubMed, National Guideline Clearinghouse, Guidelines International Network, TRIP Database, Choosing Wisely,

2 Evidence Process for Abdominal Pain Research 11/28/2017 Systematic Literature Research Ovid Medline Database Combined Evidence Tables References 46 Observational Studies 9 Systematic Reviews and Meta-Analyses 8 Physician reviews *Note: due to overlapping search results, a number of abstracts screened were duplicated across PICOs but only appear once in the Evidence Table to avoid repetition. See specific research process flowcharts for detailed search logic and results

3 Systematic Literature Research Ovid Medline Database (01/01/ /9/2017) PICO: Diffuse or poorly localized abdominal pain with or without fever (including clinical suspicion for bowel perforation, abscess, incarcerated hernia, post-surgical complication and symptomatic abdominal aortic aneurysm) 1. Abdominal Pain/ or Visceral Pain/ 2. Abdomen/ or (abdomen or abdominal or intraabdominal or stomach* or viscera* or gut or mesogastr* or splanch* or gastric or intestin* or enteric or enteron or belly or periton* or "douglas' pouch" or mesenter* or omentum or retroperiton* or digestive tract).mp. 3. Pain/ or (pain* or ache* or discomfort or guarding).mp. 4. Intestinal Perforation/ or ((intestin* or bowel) and (perforation* or perforat* or ruptur*)).mp. 5. Abdominal Abscess/ or ((abdominal or intraabdominal) and abscess*).mp. 6. ((incarcerated or strangulated) and hernia).mp. 7. Postoperative complications/ or (("post surgical" or "post-surgical" or postsurgical or postoperative or "post operative" or "post-operative") and complication*).mp and 7 9. Aortic Aneurysm, Abdominal/ or (abdominal aortic and (aneurism or aneurysm)).mp. 10. (symptomatic or symptom* or indication* or sign or manifestation*).mp and Tomography, X-Ray Computed/ or Magnetic Resonance Imaging/ or ("CT scan" or computed tomography or CTA or MRI or MRA or magnetic resonance or imaging or bone scan or scintigraphy or HDP or MDP or 99mTc or PET or SPECT or enteroclysis or enterography or nuclear medicine or hepatobiliary or Ga-67 or Tc-99m WBC or In-111 WBC).mp. 13. (guideline or meta-analysis or practice guideline or systematic reviews or validation studies).pt. or (systemati* or randomiz* or guidance or guideline or recommendation or meta-analysis or metaanalysis).mp and or 4 or 5 or 6 or 8 or 11 or and 13 and limit 16 to (english language and humans) 18. limit 17 to "all adult (19 plus years)" 19. limit 18 to yr="2010 -Current" 495 results; after duplicates removed, 421 results 1 Randomized Controlled Trial Excluded 25 Abstracts Screened 5 Randomized Controlled Trials 4 Meta-analyses 3 Systematic Reviews 2 Validation Studies 2 Comparative Studies 2 Prospective Studies 2 Retrospective Studies 1 Clinical Trial 1 Research Study 13* Evidence Table References *note: due to overlapping search results, a number of abstracts screened were duplicated across PICOs but only appear once in the Evidence Table to avoid repetition

4 Systematic Literature Research Ovid Medline Database (01/01/ /10/2017) PICO: Abdominal/Epigastric pain with suspected peptic ulcer disease 1. exp Peptic Ulcer/ or "gastric ulcer".mp. or ((peptic or stomach or duodenal or curling or antral) and (ulcer* or ulcerat*)).mp. 2. (epigastric or epigastrium).mp. and (Pain/ or pain*.mp. or discomfort.mp.) 3. 1 or 2 4. Tomography, X-Ray Computed/ or Magnetic Resonance Imaging/ or ("CT scan" or computed tomography or CTA or MRI or MRA or magnetic resonance or imaging or bone scan or scintigraphy or HDP or MDP or 99mTc or PET or SPECT or enteroclysis or enterography or nuclear medicine or hepatobiliary or Ga-67 or Tc-99m WBC or In-111 WBC).mp. 5. (guideline or meta-analysis or practice guideline or systematic reviews or validation studies).pt. or (systemati* or randomiz* or guidance or guideline or recommendation or meta-analysis or metaanalysis).mp and 4 and 5 7. limit 6 to (english language and humans and "all adult (19 plus years)") 8. limit 7 to yr="2012 -Current" 18 results; after duplicates removed, 14 results 2 Abstracts Screened 0* Evidence Table References *note: due to overlapping search results, a number of abstracts screened were duplicated across PICOs but only appear once in the Evidence Table to avoid repetition

5 Systematic Literature Research Ovid Medline Database (01/01/ /10/2017) PICO: Right lower quadrant pain with suspected appendicitis 1. Appendicitis/ or appendicitis.mp. [mp=title, abstract, original title, name of substance word, subject heading word, keyword heading word, protocol supplementary concept word, rare disease supplementary concept word, unique identifier, synonyms] 2. (RLQ or (right lower and (quadrant or abdomen or abdominal))).mp. [mp=title, abstract, original title, name of substance word, subject heading word, keyword heading word, protocol supplementary concept word, rare disease supplementary concept word, unique identifier, synonyms] 3. Pain/ or pain*.mp. or tenderness.mp. or guarding.mp. [mp=title, abstract, original title, name of substance word, subject heading word, keyword heading word, protocol supplementary concept word, rare disease supplementary concept word, unique identifier, synonyms] 4. 2 and 3 5. Appendix/ or appendix.mp. or appendiceal.mp. or appendicular.mp. [mp=title, abstract, original title, name of substance word, subject heading word, keyword heading word, protocol supplementary concept word, rare disease supplementary concept word, unique identifier, synonyms] 6. (perforat* or ruptur* or burst or inflammat* or inflam*).mp. or Inflammation/ or infect*.mp. or Infection/ [mp=title, abstract, original title, name of substance word, subject heading word, keyword heading word, protocol supplementary concept word, rare disease supplementary concept word, unique identifier, synonyms] 7. 5 and or 4 or 7 9. Tomography, X-Ray Computed/ or Magnetic Resonance Imaging/ or ("CT scan" or computed tomography or CTA or MRI or MRA or magnetic resonance or imaging or bone scan or scintigraphy or HDP or MDP or 99mTc or PET or SPECT or enteroclysis or enterography or nuclear medicine or hepatobiliary or Ga-67 or Tc-99m WBC or In-111 WBC).mp. 10. (guideline or meta-analysis or practice guideline or systematic reviews or validation studies).pt. or (systemati* or randomiz* or guidance or guideline or recommendation or meta-analysis or metaanalysis).mp and 9 and limit 11 to (english language and humans and yr="2014 -Current" and "all adult (19 plus years)") 42 results, after duplicates removed, 33 results Excluded 1 Clinical Study 10 Abstracts Screened 2 Retrospective Studies 2 Multicenter Studies 1 Randomized Controlled Trial 1 Evaluation Study 1 Clinical Trial 1 Validation Study 1 Meta-analysis 1 Prospective Study 11 Evidence Table References *note: due to overlapping search results, a number of abstracts screened were duplicated across PICOs but only appear once in the Evidence Table to avoid repetition

6 Systematic Literature Research Ovid Medline Database (01/01/ /12/2017) PICO: Right upper quadrant pain with suspected hepatobiliary disease with or without jaundice, with or without known gallbladder calculi 1. exp biliary tract diseases/ 2. cholangiocarcinoma.mp. or Cholangiocarcinoma/ 3. ("porcelain gallbladder" or gallstone* or (gall adj2 stone*) or jaundice*).mp. [mp=title, abstract, original title, name of substance word, subject heading word, keyword heading word, protocol supplementary concept word, rare disease supplementary concept word, unique identifier, synonyms] 4. ((biliary or hepatobiliary or bile duct or gallbladder) and (stricture or stenosis or obstruction or mass or calcul* or stone* or staghorn)).mp or 2 or 3 or 4 6. (RUQ or (right upper and (quadrant or abdomen or abdominal))).mp. and (Pain/ or pain*.mp. or discomfort.mp. or tenderness.mp. or guarding.mp.) [mp=title, abstract, original title, name of substance word, subject heading word, keyword heading word, protocol supplementary concept word, rare disease supplementary concept word, unique identifier, synonyms] 7. 5 or 6 8. Tomography, X-Ray Computed/ or Magnetic Resonance Imaging/ or ("CT scan" or computed tomography or CTA or MRI or MRA or magnetic resonance or imaging or bone scan or scintigraphy or HDP or MDP or 99mTc or PET or SPECT or enteroclysis or enterography or nuclear medicine or hepatobiliary or Ga-67 or Tc-99m WBC or In-111 WBC).mp. 9. (guideline or meta-analysis or practice guideline or systematic reviews or validation studies).pt. or (systemati* or randomiz* or guidance or guideline or recommendation or meta-analysis or metaanalysis).mp and 8 and limit 10 to (english language and humans and yr="2015 -Current" and "all adult (19 plus years)") 84 results, after duplicates removed 62 results 7 Abstracts Screened 5 Evidence Table References *note: due to overlapping search results, a number of abstracts screened were duplicated across PICOs but only appear once in the Evidence Table to avoid repetition

7 Systematic Literature Research Ovid Medline Database (01/01/ /12/2017) PICO: Left lower quadrant pain with suspected diverticulitis 1. exp Diverticulitis, Colonic/ or exp Diverticulitis/ or diverticulitis.mp. or (diverticul* adj1 disease*).mp. 2. (LLQ or (left lower and (quadrant or abdomen or abdominal))).mp. and (Pain/ or pain*.mp. or discomfort.mp. or tenderness.mp. or guarding.mp.) 3. Tomography, X-Ray Computed/ or Magnetic Resonance Imaging/ or ("CT scan" or computed tomography or CTA or MRI or MRA or magnetic resonance or imaging or bone scan or scintigraphy or HDP or MDP or 99mTc or PET or SPECT or enteroclysis or enterography or nuclear medicine or hepatobiliary or Ga-67 or Tc- 99m WBC or In-111 WBC).mp. 4. (guideline or meta-analysis or practice guideline or systematic reviews or validation studies).pt. or (systemati* or randomiz* or guidance or guideline or recommendation or meta-analysis or metaanalysis).mp or and 4 and 5 7. limit 6 to (english language and humans and yr="2013 -Current" and "all adult (19 plus years)") 33 results; after duplicates removed 25 results 9 Abstracts Screened 1 Systematic Review 1 Randomized Controlled Trial 1 Comparative Study 1 Prospective Study 1 Validation study 1 Retrospective study 1 Research study 7 Evidence Table References *note: due to overlapping search results, a number of abstracts screened were duplicated across PICOs but only appear once in the Evidence Table to avoid repetition

8 Systematic Literature Research Ovid Medline Database (01/01/ /12/2017) PICO: Pancreatitis Pancreatitis/cl, di, dg, pa, su [Classification, Diagnosis, Diagnostic Imaging, Pathology, Surgery] AND (mri or mra or magnetic resonance or CT or computed tomography or cta or spect or bone scan or PET or imaging).mp. [mp=title, abstract, original title, name of substance word, subject heading word, keyword heading word, protocol supplementary concept word, rare disease supplementary concept word, unique identifier, synonyms] NOT (case adj2 (report or study or reports or studies)).mp. [mp=title, abstract, original title, name of substance word, subject heading word, keyword heading word, protocol supplementary concept word, rare disease supplementary concept word, unique identifier, synonyms] limit to (english language and humans and yr="2014 -Current" and "all adult (19 plus years) 143 results; after duplicates removed 102 results Excluded 8 Abstracts Screened 8 Observational Studies 1 Evaluation study 1 RCT 2 Evidence Table References *note: due to overlapping search results, a number of abstracts screened were duplicated across PICOs but only appear once in the Evidence Table to avoid repetition

9 Systematic Literature Research Ovid Medline Database (01/01/ /9/2017) PICO: Abdominal Pain with nausea, obstipation, vomiting, and/or distention with suspected small bowel obstruction (high grade, low-grade or intermittent), large bowel obstruction, pseudoobstruction, ileus and gastric outlet obstruction 1. (((intestin* or bowel or pseudointestin* or colon* or gastric outlet or sigmoid or duoden*) and (obstruction or pseudoobstruction or volvulus or adhesion or bezoar)) or (Ogilvie* and (syndrome or disease)) or ileus or intussusception).mp. 2. intestinal obstruction/ or afferent loop syndrome/ or duodenal obstruction/ or ileus/ or intestinal pseudo-obstruction/ or colonic pseudo-obstruction/ or intestinal volvulus/ or intussusception/ 3. 1 or 2 4. Tomography, X-Ray Computed/ or Magnetic Resonance Imaging/ or ("CT scan" or computed tomography or CTA or MRI or MRA or magnetic resonance or imaging or bone scan or scintigraphy or HDP or MDP or 99mTc or PET or SPECT or enteroclysis or enterography or nuclear medicine or hepatobiliary or Ga-67 or Tc-99m WBC or In-111 WBC).mp. 5. (guideline or meta-analysis or practice guideline or systematic reviews or validation studies).pt. or (systemati* or randomiz* or guidance or guideline or recommendation or meta-analysis or metaanalysis).mp and 4 and 5 7. limit 6 to (english language and humans and yr="2012 -Current" and "all adult (19 plus years)") 55 results; after duplicates removed, 41 results 4 Abstracts Screened 1 Meta-analysis 1 Randomized Controlled Trial 1 Comparative Study 1 Prospective study 2 Evidence Table References *note: due to overlapping search results, a number of abstracts screened were duplicated across PICOs but only appear once in the Evidence Table to avoid repetition

10 Evidence Process for IBD & IBS Research Systematic Literature Research Ovid Medline Databases (01/01/ /02/2017) 51 Results Inflammatory Bowel Disease (IBD) & Irritable Bowel syndrome (IBS) combined search strategy: Search run on 11/02/2017 (((Crohn* or Crohn* Disease) or (Colitis, Ulcerative) or (Inflammatory Bowel Disease*) or (Regional Enteritis) or (Crohn* Enteritis) or Ileocolitis or (Granulomatous Colitis)) OR ((irritable bowel syndrome) or IBS or (functional bowel disease) or (functional bowel disorder) or (functional bowel syndrome) or (irritable colon) or (mucous colitis))) AND (CT or CTA or (computed tomography) or (computed tomography angio*) or MRI or MRA or (magnetic resonance) or (magnetic resonance imaging) or (CT entero*) or (MR entero*) or cholescintigraphy or (hepatobiliary scintigraphy) or (hepatobiliary scan) or HIDA or (Gallium 67 scintigraphy) or (Gallium scan) or (Ga-67) or (99mTc WBC) or (Tc-99m WBC) or (indium scan) or (Indium 111) or (111In WBC) or PET or (PET scan*)) AND ((systemati* review) or (randomiz* control*) or RCT or (randomize* control* trial*) or guidance or guideline or recommendation or (meta analysis) or (meta-analysis)) AND Limit: English, Human, Adult Limit: year= (2010 to present) 6 Abstracts Screened 2 Comparative Studies 2 Meta-analyses 1 Randomized Controlled Trial 1 Retrospective Study 7 Evidence Table References *note: due to overlapping search results, a number of abstracts screened were duplicated across PICOs but only appear once in the Evidence Table to avoid repetition

11 Systematic Literature Research Ovid Medline Database (01/01/ /2/2017) PICO: Mesenteric Ischemia mesenteric ischemia.mp. or Mesenteric Ischemia/ OR ischemic colitis OR (mesenteric and (bowel or intestinal or gastrointestinal)).mp. [mp=title, abstract, original title, name of substance word, subject heading word, keyword heading word, protocol supplementary concept word, rare disease supplementary concept word, unique identifier, synonyms] AND (mri or mra or magnetic resonance or CT or computed tomography or cta or spect or bone scan or PET or imaging).mp. [mp=title, abstract, original title, name of substance word, subject heading word, keyword heading word, protocol supplementary concept word, rare disease supplementary concept word, unique identifier, synonyms] NOT (case adj2 (report or study or reports or atudies)).mp. [mp=title, abstract, original title, name of substance word, subject heading word, keyword heading word, protocol supplementary concept word, rare disease supplementary concept word, unique identifier, synonyms] Limit to (english language and humans and yr="2016 -Current") 59 results 4 Abstracts Screened 2 Retrospective studies 1 Review 1 Prospective Study 4 Evidence Table References